Best Practice
Establishment of a National Community of Practice for internationally trained skilled nurses

In this blog, Emma and Kevin, each qualified skilled nurse advisors, discuss why they arrange the National Community of Practice for Internationally Trained Nurses, the impact they’ve had on its members up to now and what their hopes are for the long run. Emma Perry (@EmmaPerry2007) is Mental Health Nursing Advisor for International Recruitment at NHS England and Director of Adult Mental Health Nursing at Black Country Healthcare NHS Foundation Trust, while Kevin Fernandez (@k9fernandez) is a Lecturer in Adult Nursing and International Head of the Three Counties School of Nursing and Midwifery on the University of Worcester.
Before and particularly through the COVID-19 pandemic, there was growing evidence highlighting the necessity to support the well-being of healthcare employees and ensure a culture of supervision, kindness and compassion (One Voice, 2021; NHS Reset and NHS Confederation, 2020; West et al., 2020). Research has shown that regular Restorative Clinical Surveillance (RCS) provides healthcare professionals with significant health advantages and supports retentionDavenport, 2013; Wallbank, 2010). The principle of the Professional Nursing Advocate (PNA) model (adapted from the Professional Midwifery Advocate) was to reply strategically to national initiatives, particularly in supporting the mental health and wellbeing elements of the NHS People Plan 2020/21 (NHS England, 2020b) and the NHS Long Term Plan (NHS England, 2019). Model for Promoting Education, Quality and Improvement (A-EQUIP) (NHS England, 2021a; 2021b) has demonstrated a variety of advantages, including supporting healthcare staff and repair users and promoting nurse education and development.
The National NHS England PNA scheme has allocated places specifically for internationally educated nurses (IENs). The national Community of Practice (CoP) for IEN PNA was established in August 2022 to acknowledge and support this group of nursing colleagues. As set out in the unique terms of reference, which were reviewed and approved by the Presidents in January 2023, the objectives of the Conference of the Parties are:
- providing a reflective, restorative and courageous space for IEN PNA qualified and trainees,
- facilitating clinical support networks and
- to amplify the voice of IEN PNA.
This is in step with two of the 4 #StayAndThrive packages of “belonging” and “maximizing personal and professional development” identified in research on global migration and retention of nurses abroad (Pressley et al., 2022). Moreover, evidence from the Workforce Race Equality Standard reports (NHS England, 2023) found that black and minority ethnic employees have measurably worse day-to-day experiences in NHS organizations and face more barriers to profession progression. When we first met in the summertime of 2022, we talked about how we could “amplify the whispers” of our IEN colleagues who don’t speak out in the identical way and loudly as their white colleagues within the UK NHS. This could potentially be attributed to known cultural and language barriers, but can also be in step with the NHS Third People’s Promise (NHS England, 2020a) statement; “each of us has a voice that counts.”
Group members collectively agreed on the definition of IEN as culturally and linguistically diverse nurses who were trained abroad or within the UK. The CoP conference meets via MS Teams on the third Thursday of every month and features presentations from members and guest speakers who work with or support PNA, reflecting the 4 key elements of the A-EQUIP model (NHS England, 2021a; 2021b). To date, we have now built a community of nurses sharing best practices in supporting the health and well-being of IEN staff, celebrating one another’s journey and successes in PNA (see photo 1). From January to June 2023, 100% (n=37) of members who accomplished the member feedback survey said they might participate again and would recommend it to other International Nurse PNAs. Furthermore, 100% (n=37) have an motion or idea they are going to take to support their skilled development and/or well-being. We proceed to take care of and promote the community while considering how we proceed to guage the impact it has on members.
Photo 1: Example of feedback from CoP IEN PNA members
We are energized and inspired after each community of practice meeting. We hope that every one nurses, especially international nurses, will reap the benefits of the chance to coach as a PNA and join a community of practice that promotes and sustains their personal well-being and skilled development.
Further information concerning the community of practice, case studies and resources on IEN PNA might be found here Nurses with international education PNA – Professional Nurse Advocate (PNA) – FutureNHS collaboration platform.
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